Structural Features And Factors In The Development Of Congenital Heart Disease In CHildren Who Underwent Surgery At The Andijan Regional CHildren’s Multidisciplinary Medical Center, Republic Of Uzbekistan, In 2021–2025

Abstract

Introduction. Congenital heart disease remains a leading cause of childhood morbidity and disability. The problem is becoming increasingly important because of the growing proportion of severe and combined forms, whose pattern and prognosis may be influenced by regional and ethnic factors. Therefore, continuous monitoring of CHDs is important for improving early diagnosis, cardiac surgical care, and rehabilitation. Objective. To determine the structural characteristics of congenital heart defects (CHDs) and clinical and anamnestic factors among children who underwent surgery at the Andijan Regional Children’s Multidisciplinary Medical Center in 2021–2025. Materials and methods. The study included 927 children with CHDs treated in 2021–2025, of whom 497 underwent surgery. The medical records of all 927 children were analyzed retrospectively, while 128 children from the overall cohort were additionally examined prospectively. The structure of heart defects, patients’ age and place of residence, clinical manifestations, comorbid conditions, maternal pregnancy history, and family history were assessed. Quantitative variables were compared using the Mann–Whitney U test and the Kruskal–Wallis test. Categorical variables were analyzed using Pearson’s chi-square test and Fisher’s exact test. Differences were considered statistically significant at p<0.05. Results. Among the 497 operated children, ventricular septal defect (36.4%), patent ductus arteriosus (29.8%), and atrial septal defect (20.9%) predominated. Tetralogy of Fallot accounted for 5.8%, atrioventricular canal defect for 3.0%, and transposition of the great arteries for 2.2%. In 2023–2025, the proportion of operations for complex and critical CHDs increased. The main clinical manifestations included perioral cyanosis, respiratory failure, and heart failure. Maternal histories frequently included infections during pregnancy, gestosis, impaired uteroplacental blood flow, and somatic diseases; hereditary burden and consanguineous marriages were also recorded. Conclusion. Ventricular septal defect, patent ductus arteriosus, and atrial septal defect predominated among surgically corrected CHDs in the Andijan region. The findings support regional monitoring of CHD patterns, early diagnosis, improved patient referral, and multidisciplinary follow-up.